ZJ6-33723-93557

1 vaccination 8 coded responses 9 check-ins 8 free-text entries 1 call case

Sex: Female
Age at first dose: 61-65
ZIP prefix: 329 / FL
Registered: 2021-05-24

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-05-19
Dose 1 — Moderna
2021-05-24
Registered in v-safe
2021-05-24
Survey response — days 1–6 daily, dose 1
MedDRA: Parosmia — Feeling: Good · Fatigue or tiredness

Free text: Yes. My sense of smell ahas bee off since 5/20/21. Its an idd smell that is hard to describe and it seems to occur around bedtime.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-25
Survey response — days 1–6 daily, dose 1
MedDRA: Parosmia — Feeling: Good · Fatigue or tiredness

Free text: My sense of smell is off a little. It occurs just before bedtimevand during bedtime. Its a smell of like a spice and floral which is hard to describe. Last night it was slight and not as intense as the previous 6 days.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Survey response — day 7, dose 1
MedDRA: Dizziness — Feeling: Fair · Fatigue or tiredness

Free text: I also felt a little light headed today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-02
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-06-09
Survey response — day 21, dose 1
MedDRA: Anxiety, Fatigue, Myalgia, Pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: Chronic fatigue, achey bones and muscles. A lot of anxiety.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-30
Survey response — day 42, dose 1
MedDRA: Anxiety, Blood pressure fluctuation, Emergency care, Energy increased, Fatigue, Headache, IVth nerve paralysis, Pre-existing disease, Stress, VIth nerve paralysis, Vision blurred — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Symptoms: Developed 6th nerve palsy, up & down blood pressure, fatigue increase, sporadic energy, headaches, increase in stress and anxiety. B4 the 1st shot I was perfectly fine. I had covid in december 2020. Recovered fine until 1st shot. · Healthcare visit (other): Was to ER twice in 1 week. Blurry vision, major headaches etc.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-30
Report sent to call center — day 42, dose 1
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-07-06
Call 1 — Left Voicemail
2021-08-20
Survey response — 3 months, dose 1
MedDRA: Giant cell arteritis, Reaction to previous exposure to any vaccine — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I now have been diagnosed with Giant Cell Arteritis. With my last response to you I told you what occurred after 1st dose of moderna. Its been a long 4 months of not knowing until today after having biopsy what came out of the vaccine.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-11-18
Survey response — 6 months, dose 1
MedDRA: Giant cell arteritis — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Due to having to take prednisone, I had a lot of side affects. I now have Temporal Arteritis from vaccine.

MedDRA releases: 2024-11 · check-in free text available
2022-05-19
Survey response — 12 months, dose 1
MedDRA: Balance disorder, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Severe exhaustion. I continue from time to time to having balance issues.

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-05-19	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-06-30	Unsuccessful

Free text

Release 8 — days 1–6 daily, dose 1

2021-05-24

Systemic reaction (other): Yes. My sense of smell ahas bee off since 5/20/21. Its an idd smell that is hard to describe and it seems to occur around bedtime.

2021-05-25

Systemic reaction (other): My sense of smell is off a little. It occurs just before bedtimevand during bedtime. Its a smell of like a spice and floral which is hard to describe. Last night it was slight and not as intense as the previous 6 days.

Release 8 — day 7, dose 1

2021-05-26

Systemic reaction (other): I also felt a little light headed today.

Release 9 — day 21, dose 1

2021-06-09

Symptoms: Chronic fatigue, achey bones and muscles. A lot of anxiety.

Release 9 — day 42, dose 1

2021-06-30

Symptoms: Developed 6th nerve palsy, up & down blood pressure, fatigue increase, sporadic energy, headaches, increase in stress and anxiety. B4 the 1st shot I was perfectly fine. I had covid in december 2020. Recovered fine until 1st shot.

Healthcare visit (other): Was to ER twice in 1 week. Blurry vision, major headaches etc.

Release 9 — 3 months, dose 1

2021-08-20

Symptoms: I now have been diagnosed with Giant Cell Arteritis. With my last response to you I told you what occurred after 1st dose of moderna. Its been a long 4 months of not knowing until today after having biopsy what came out of the vaccine.

Release 10 — 6 months, dose 1

2021-11-18

Symptoms: Due to having to take prednisone, I had a lot of side affects. I now have Temporal Arteritis from vaccine.

Release 11 — 12 months, dose 1

2022-05-19

Symptoms: Severe exhaustion. I continue from time to time to having balance issues.

Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that survey response. The CDC cut some text off at about 250 characters: symptoms in every release, and the other two fields in releases 9-12. Those entries are marked "cut off by CDC".

MedDRA terms by release

Field	Preferred term	2021-09	2023-04	2024-11
HCVO	Emergency care	✓	✓	✓
HCVO	Headache	✓	✓	✓
HCVO	Vision blurred	✓	✓	✓
SD	Anxiety	✓	✓	✓
SD	Balance disorder	·	·	✓
SD	Blood pressure fluctuation	✓	✓	✓
SD	Energy increased	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Giant cell arteritis	✓	·	✓
SD	Headache	✓	·	✓
SD	IVth nerve paralysis	○	✓	○
SD	Myalgia	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pre-existing disease	✓	·	✓
SD	Reaction to previous exposure to any vaccine	✓	·	✓
SD	Stress	✓	✓	✓
SD	VIth nerve paralysis	✓	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Parosmia	✓	✓	✓

✓ active code · ○ coded but marked inactive · blank = not in that release